Bodgaun Medical Camp

Nepal. November 2018

This is the second medical camp organised by Jay Nepal International for the Majhi community living in Bodgaun, Sindhupalchowk in central Nepal. The Majhi are a very marginalised and poverty stricken community that lacks access to many essential resources, which was only made worse by the earthquake in 2015 (this region was the epicentre) as well as to basic health services.

Earlier this year Jay Nepal International completed the construction of a medical centre for this particular community with the hope that it will support and provide the health care that is so greatly needed in Bodgaun and the surrounding areas.

Jay Nepal invited 1 GP and 2 Gynaecologists to treat patients and over 150 people showed up to take advantages of the free services.

Children are among the many waiting in line at the opening of the medical camp.

A father and son register their family.

More women begin to queue for registration

A young boy and his grandfather at the registration table.

Portrait of a Majhi woman.

Jay Nepal International and village volunteers sorting through patient records.

Pictured is a little boy receiving an ultrasound. He came into the camp, accompanied by his mother, complaining of chest pain. After the examination it became clear that he was suffering from a chest infection. People in Bodgaun live in very basic housing, usually houses made of mud, clay or stone and sometimes brick. In the winter months it gets exceptionally cold and the only way to stay warm is with an open fire. Chest infections are a common aliment as a result of this.

During this woman’s consultation it was revealed that she had a serious gynaecological infection most probably as a result of unsanitary hygiene practices. For privacy reasons her face is not pictured.

Gynaecological infections are very common for women in rural Nepal. One of the reasons for this are the many cultural taboos surrounding female body parts and menstruation. Although not in Bodgaun, Chhaupadi, the practice of ostracising women and girls from their own homes during their periods is still practised and remains a national problem. The effects of Chhaupadi are extremely dehumanising and psychologically stressful, with young girls told that they will bring bad luck to their families if they enter their own homes during menstruation.

Even in regions where Chhaupadi is not practiced, taboos surrounding menstruation still affect Nepalese women and girls. The Nepali Times reports that today many households in Kathmandu still prohibit menstruating women from entering kitchens or temples, from eating with the family and sleeping on their beds. These ideologies condition women to view their bodies as unclean and to devalue themselves because they take the blame for any misfortune their families may experience. All this contributes to a wider disregard of women, girls and their bodies.

Therefore, another reason for gynaecological infections in the rural regions of Nepal is the lack of understanding and education about female hygiene. Women and girls in these communities have access to very few sanitary resources. Some reuse the same menstrual products/cloths for days and are only able to wash them with unfiltered water sources.

In order to prevent any misconception regarding menstrual hygiene girls should be educated about the process and significance of menstruation, the use of proper pads or absorbents and proper disposal. This can be achieved by giving them proper training and health education (by teachers, family members, health educators, and media).

Dr. Suman gives a woman an ultrasound and discovers she has a tumour on her uterus. It would require her to visit a hospital and have it removed.

A picture of a young teenage girl receiving an ultrasound. It was found that she is a few weeks pregnant with her first child. She came into the camp alone with abdominal pain and was worried. According to the UNFPA girls aged 15-19 are twice as likely as women aged 20-24 to die during pregnancy. One of the common health risks of early pregnancy is fistula. Because young women are not physically developed enough to deliver a child, they often face prolonged labor. During labor, the baby exerts pressure against soft tissues in the mother's pelvis. This can cause some tissues to die, leaving a hole or a fistula. Another common problem associated with early pregnancy is uterine prolapse, which affects 600,000 women in Nepal. Among the causes of this condition are applying pressure during delivery, strenuous manual labor after childbirth, and giving birth and a young age. Some effects of uterine prolapse include pain during urination, difficulties during sexual intercourse and social stigmatization.

This girl was extremely malnourished and as a result her bones have not developed properly. Major causes of malnutrition include poverty and food prices, dietary practices and agricultural productivity, with many individual cases being a mixture of several factors. If undernutrition occurs during pregnancy, or before the age of 2 it may result in permanent problems with physical and mental development. A lack of adequate breastfeeding, also leading to malnutrition in infants and children, is associated with the deaths of an estimated one million children annually.

The two Gynecologists giving a talk about female hygiene to a group of students from the school nearby.

Before seeing the Gynaecologists, women were instructed to wait in this room where they would receive a briefing about what to expect from the doctors. Even though many of these women are adults, majority of them have never been to a Gynaecologist before.

Women wait in line for registration to start.

Portrait of an 85 year old man while he has his vitals checked.

Dr. Suman, the camp’s GP, trying to organise the flow of patients.

Portrait of a little boy in the waiting room.

Portrait of a village elder.

Although you are unable to see from this photo, the woman pictured is unable to walk. Her feet and toes are all misaligned. I was told later that this might have been a result of a broken bone that was not treated and thus had not healed correctly. She holds her sons hand for support before seeing the doctor.

In many rural communities in Nepal women take on most of the manual labour. They do all this work outdoors, sometimes in harsh conditions, wearing nothing but flip flops and injuries are inevitable. Without the proper care for their wounds, even the minor ones, this often leads to infections and possible blood poisoning.

A little girl who came to see Dr. Suman about an itchy scalp. She was diagnosed with scabies. Scabies is an infestation of tiny mites on the skin. It causes a small red rash and intense itching. This infection is very contagious. It often spreads from child to child while children are sleeping together in the same bed or have close personal contact and poor hygiene.

The lady being examined in this photo came into the camp exhibiting symptoms of heart failure. She had shortness of breath, extreme fatigue and weakness. She also had swelling (edema) of the legs, ankles and feet and rapid and heartbeat. According to Dr. Suman at this point there was not a lot of treatment that would benefit her and unfortunately her prognosis was not very good.

One of the land owners. She and her husband donated some of their land to Jay Nepal International for the construction of the medical centre last June.